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Money matters: an analysis of advanced cancer couples’ communication about financial concerns

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Abstract

Even for the insured, cancer treatment can be expensive and financially burdensome for families, especially in advanced disease.

Purpose

To determine if advanced cancer patient–caregiver spousal dyads identified and/or discussed financial concerns.

Methods

Advanced cancer spousal dyads (n = 26) were asked to discuss their concerns (including finances) for 10 min. Discussions were audio-recorded and transcripts were analyzed for content and depth. We used the constant comparative analysis to analyze communication and demographic data from those who identified financial concerns relevant to cancer treatment.

Results

Of the 26 couples identifying finances as a concern relevant to cancer, there was variability in perception of their overall financial situation, and roughly a third had discordant reports on the degree of financial concern. Thirty-five percent of dyads (n = 9) did not discuss finances during the audio-recorded discussions; for the other dyads, financial conversations varied in depth and breadth for specific concerns.

Conclusions

Couples were discordant in reports of concern about finances and perceptions of their financial situations. Even if finances were identified as a concern, many couples chose not to discuss financial concerns in depth. Some degree of shielding or avoidance between spouses may be beneficial, but couple financial discussions are important, especially when decisions may impact long-term plans. More research is needed to determine how to facilitate financial conversations to improve patient’s and caregiver’s well-being.

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Data availability

The data that support the findings of this study are available from the corresponding author, MR, upon reasonable request.

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Funding

This work was supported by the American Cancer Society [ACS MRSG 13-234-01-PCSM, PI: Reblin].

Author information

Authors and Affiliations

  1. College of Health and Human Sciences, School of Nursing, Purdue University, 502 N. University Street, West Lafayette, IN, 47907-2069, USA

    Jiayun Xu

  2. College of Nursing, University of Utah, 10 2000 E, Salt Lake City, UT, 84112, USA

    Lee Ellington

  3. Family Translational Research Group, New York University, 137 E 25th Street, 6th Floor, New York, NY, 10010, USA

    Richard E. Heyman

  4. Department of Health Outcomes & Behavior, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA

    Susan T. Vadaparampil & Maija Reblin

Authors
  1. Jiayun Xu
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  2. Lee Ellington
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  3. Richard E. Heyman
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  4. Susan T. Vadaparampil
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  5. Maija Reblin
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Corresponding author

Correspondence to Maija Reblin.

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Written informed consent was obtained from all individual participants included in the study.

Ethics statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Chesapeake IRB, MCC 18495) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflict of interest.

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Xu, J., Ellington, L., Heyman, R.E. et al. Money matters: an analysis of advanced cancer couples’ communication about financial concerns. Support Care Cancer 28, 2239–2246 (2020). https://doi.org/10.1007/s00520-019-05045-z

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  • DOI: https://doi.org/10.1007/s00520-019-05045-z

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